Surgical instruments such as scalpels, clamps, suturing devices, knot pushers, etc., are commonly used in various types of surgery, including conventional surgeries as well as minimally invasive surgeries. Minimally invasive surgical techniques have emerged as an alternative to conventional surgical techniques to perform a plurality of surgical procedures. Minimally invasive procedures differ from conventional surgical procedures in that a plurality of devices may be introduced into the body through a small incision. As a result, trauma to the body is greatly reduced, thereby decreasing the recovery time of the patient.
Many conventional surgical procedures have been performed using minimally invasive techniques. One challenge presented when performing a surgical procedure is to provide the surgeon or other user with the ability to firmly hold the surgical instrument during its use, with reduced chance of the user losing grasp of the surgical instrument while also providing the user with effective control of the surgical instrument, especially the distal end thereof which is typically the “functional” end of the instrument which actually interacts with the patient's tissue or otherwise performs the procedure.
One challenge during surgeries, including minimally invasive techniques, is to position and apply sutures to an area of interest. Commonly, a suture will be required to approximate at least two pieces of tissue. In conventional surgical techniques, the surgeon will approximate the tissue pieces by forcing a needle and suture material through various portions of the tissue to be approximated, and tying a knot in the suture material resulting in approximation. However, even in conventional surgical techniques the user's access to the tissue to be sutured can be limited and/or involve small/delicate tissue requiring fine operational movement of the instrument. In minimally invasive surgical techniques, the surgeon's access to the approximation site can be greatly reduced. Commonly, a surgical device will attach the suture material to the tissue. The surgeon will remotely form a knot in the suture material and advance the knot to the area of interest with a “knot pusher,” thereby approximating the tissue. Thereafter, the knot pusher is removed from the body and a suture cutting device is inserted to cut the surplus suture material.
Several knot pushing devices are known. These devices permit an operator to push suture knots which have been formed extracorporeally towards tissue to be sutured. For example, U.S. Pat. No. 5,769,863, issued to Garrison et al., discloses a surgical knot pusher having an elongated body connected to a pushing head. The pushing head engages a portion of suture material containing a knot and is advanced to the area of interest, thereby “throwing” the knot. Once the suture knot is placed the knot pushing device is removed and a cutting element is introduced into the body and cuts the remaining suture material. The remaining suture material is then removed. Another example of a knot pusher is presented in U.S. Pat. No. 6,860,890, entitled “Surgical Knot Pushing Device and Method of Use,” which discloses a system using an elongated catheter-like device capable of intracorporeally positioning and applying a suture knot to an area of interest via minimally-invasive surgical openings. The knot pushing system allows the operator to cut and remove surplus suture material using the knot pushing device.
Many medical procedures are delicate procedures involving small and/or enclosed spaces where a user may only be able to advance the tips of his/her fingers. Moreover, it may be desirable to provide the user with devices and methods which provide tactile feedback that is stronger than that provided by larger hand-held or machine-held devices.